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MR. LARRY WAYNE TAYLOR

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1770552077

Individual Registrant:
MR. LARRY WAYNE TAYLOR 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
6554 AARON DR  FAIRFIELD, AL 35214 US
Tel: 205-786-5022  Fax: 205-786-5028

Contact information for business:
2147 RIVERCHASE OFFICE RD  BIRMINGHAM, AL 35244-1836 US
Tel: 205-403-8902  Fax: 205-982-7882

Registration Information:
NPI: 1770552077
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
ALDO453

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
RAILROAD MEDICARE080143157AL01
000027610AL05
BLUE CROSS BLUE SHIELD051027665AL01




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